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Legal agreements: barriers and enablers to global equitable COVID-19 vaccine access

The Lancet, 2020-09, Vol.396 (10254), p.800-802 [Peer Reviewed Journal]

2020 Elsevier Ltd ;2020. Not withstanding the ProQuest Terms and Conditions, you may use this content in accordance with the associated terms available at https://www.elsevier.com/legal/elsevier-website-terms-and-conditions ;2020. Elsevier Ltd ;2020 Elsevier Ltd. All rights reserved. 2020 Elsevier Ltd ;ISSN: 0140-6736 ;EISSN: 1474-547X ;DOI: 10.1016/S0140-6736(20)31873-0 ;PMID: 32910908

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Title:
Legal agreements: barriers and enablers to global equitable COVID-19 vaccine access
Author: Phelan, Alexandra L ; Eccleston-Turner, Mark ; Rourke, Michelle ; Maleche, Allan ; Wang, Chenguang
Subjects: Accountability ; Agreements ; Children ; Civil society ; Comment ; Contracts ; Coronavirus Infections - economics ; Coronavirus Infections - prevention & control ; Coronaviruses ; COVID-19 ; COVID-19 Vaccines ; Developing countries ; Drug Industry - legislation & jurisprudence ; Epidemics ; Global Health - economics ; Global Health - legislation & jurisprudence ; Government procurement ; Health Equity - economics ; Humans ; Immunization ; Influenza ; Intellectual property ; International ; International agreements ; LDCs ; Legal documents ; Manufacturers ; Manufacturing ; Nationalism ; Pandemics ; Participation ; Profits ; Property rights ; Public good ; Public health ; Purchasing ; Severe acute respiratory syndrome coronavirus 2 ; Transparency ; Vaccines ; Viral diseases ; Viral Vaccines - economics ; Viral Vaccines - supply & distribution ; Viruses
Is Part Of: The Lancet, 2020-09, Vol.396 (10254), p.800-802
Description: In the lead-up to the World Health Assembly (WHA) in May, 2020, current and former politicians and civil society leaders from around the world, including the President of Ghana, Nana Akufo-Addo, the Prime Minister of Pakistan, Imran Khan, and the President of South Africa and Chair of the African Union, Cyril Ramaphosa, called for a “bold international agreement” that guarantees global equitable access to vaccines as global public goods.3 At the WHA, China's President Xi Jinping stated that any Chinese vaccine developed will be a “global public good”, and contribute to “ensuring accessibility and affordability in developing countries”.4 The only resolution adopted during the truncated WHA recognised immunisation, rather than vaccines themselves, as a global public good.5 However, since then, the global legal landscape has shifted from a rhetoric of global public goods to a reality largely based on nationalism. According to WHO, there are more than 170 COVID-19 candidate vaccines in development.6 Although only eight of those vaccine candidates are now in phase 3 trials,7 some wealthy nations have secured more than 2 billion doses of potential future COVID-19 vaccines using APAs.8 APAs are legally binding contracts whereby one party, such as a government, commits to purchasing from a vaccine manufacturer a specific number or percentage of doses of a potential vaccine at a negotiated price if it is developed, licensed, and proceeds to manufacture. Global health organisations, most notably Gavi, The Vaccine Alliance, have used donor-funded AMCs to enter into APAs with vaccine manufacturers to supply a guaranteed number of vaccine doses to countries with limited profit-based markets; AMCs were used in this way for childhood pneumococcal vaccines and Ebola vaccines.11 In June, 2020, Gavi established the COVID-19 Vaccine Global Access (COVAX) AMC to use funds from donors and HIC governments to purchase a guaranteed volume supply of COVID-19 vaccines to be distributed to LMICs participating in the COVAX Facility.12 Launched in April, 2020, and co-led by Gavi, the Coalition for Epidemic Preparedness Innovations (CEPI), and WHO, the COVAX Facility is a platform for all participating governments to access a diversified portfolio of COVID-19 vaccines when they become available, distributing risk across multiple vaccine candidates. Civil society has criticised COVAX for negotiating prices that include profit rather than vaccines at cost as a global public good, the lack of transparency of contracts entered into with vaccine manufacturers, limits on civil society participation, failure to address potential impacts of intellectual property rights on pandemic vaccines, and governance questions, including the role of WHO and limited experience procuring vaccines for middle-income countries and HICs.13 The latter point led the EU to decline using the COVAX Facility for purchasing vaccines, stating that bilateral APAs enable it to access vaccines faster and at a lower cost.
Publisher: England: Elsevier Ltd
Language: English
Identifier: ISSN: 0140-6736
EISSN: 1474-547X
DOI: 10.1016/S0140-6736(20)31873-0
PMID: 32910908
Source: Coronavirus Research Database

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Legal agreements: barriers and enablers to global equitable COVID-19 vaccine access

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